卵巢低反应专家共识

卵巢低反应(POR)是卵巢对促性腺激素(Gn)刺激反应不良的病理状态。POR诊断标准满足以下3条中的2条即可:1高龄(≥40岁)或存在卵巢反应不良的其它危险因素;2前次IVF周期卵巢低反应,常规方案获卵数≤3个;3卵巢储备下降窦卵泡数(AFC)5~7个或抗苗勒管激素(AMH)0.5~1.1μg/L]。其病因主要与年龄、遗传和免疫因素、环境因素等有关。在IVF助孕中建议采用常规的Gn RHa长方案、Gn RHa短方案和Gn RHA方案进行促排卵,也可采用非传统的微刺激方案、自然周期方案等方法。另外,使用生长激素(GH)、雄激素(A)、雌激素、口服避孕药(OC)等及中医中药来预处理有利于患者治疗结局的改善。

A consensus of poor ovarian response

Poor ovarian response(POR) is the pathological state of ovarian stimulation. POR can be diagnosed when at least two of the following three features must be present: 1) advanced maternal age(aged over40 years) or any other risk factor for POR; 2) a previous POR(oocytes retrieved less than or equal to 3 in conventional protocols); 3) an abnormal ovarian reserve test(ORT) antral follicle count(AFC) <5-7 or anti-Müllerian hormone(AMH) <0.5-1.1 μg/L]. The causes of POR were mainly related with age, genetic factors, immune factors, and/or environmental factors. In IVF treatment, besides conventional Gn RHa long and short protocols, and Gn RHA protocols for ovarian stimulation, microstimulation, natural cycle scheme can be chosen. In addition, growth hormone(GH),androgen(A), estrogen, oral contraceptives(OC), and Chinese traditional medicine can be used in pretreatment which may improve the treatment outcomes.